Healthcare Provider Details

I. General information

NPI: 1184946238
Provider Name (Legal Business Name): HEATHER GAIL DAILEY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2010
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7945 MACARTHUR BLVD #101-235
CABIN JOHN MD
20818-0235
US

IV. Provider business mailing address

7945 MACARTHUR BLVD #101-235
CABIN JOHN MD
20818-0235
US

V. Phone/Fax

Practice location:
  • Phone: 202-964-1160
  • Fax:
Mailing address:
  • Phone: 202-964-1160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN960295
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR147286
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: